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HX64077217 
RA61 3  W73  Industrial  hygiene, 


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Columbia  Statoetsttp 

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College  of  Pjrsicians  anb  burgeons 
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Health -Education  S#tew  *«r*t 


INDUSTRIAL 
HYGIENE 

By  - "J 

PROF.  C.-E.  A.  WINSLOW 
College  City  of  New  York 
Curator  of  Public  Health 

Museum  of  Natural  History,  New  York 


"Mj>  people  ate  destroyed  for  lack 
of  knowledge." 

— Hosea  iv.  6. 


Published   by   the 

Health-Education    League 

8  Beacon  Street,  Room  36 
BOSTON,  MASS. 


OFFICERS 


President,  DUDLEY  A.  SARGENT,  M.D. 
Vice-President  .  H.  S.  POMEROY,  M.D. 
Secretary  Rev.  GEORGE  H.  CATE 
Treasurer A.  L.  DARROW 


DIRECTORS 

MMS.  ELLEN  H.  RICHARDS 

CHARLES  M.  GREEN,  M.D. 

HENRY  J.  BARNES,  M.D. 

MILTON  J.  ROSENAU,  M.D. 
HERMAN  F.  VICKERY,  M.D. 

MBS.  J.  D.  K.  SABINE,  M.D. 

Rev.  CHARLES  FLEISCHER 

FREDERICK  H.  PRATT,  M.D. 
FRANK  E.  BUNDY,  M.D. 


Copyright,    mil.  i>y  Health-Education  League 


Industrial  Hygiene 

C.-E.  A.  WINSLOW 

Associate  Professor  of  Biology,  College  of  th» 
City  of  New  York,  and  Curator  of  Public 
Health,  American  Museum  of  Natural 
History,  New  York 


"  It  is  but  reasonable  that  Physick  (med- 
ical science)  should  contribute  its  quota  for 
the  safety  of  Tradesmen  (industrial  workers) , 
that  they  may  follow  their  trades  without 
injuring  their  health." — Ramazzini,  "  Treat- 
ise on  the  Diseases  of  Tradesmen  "  (1670). 

"  The  canker  of  industrial  diseases  gnaws 
at  the  very  root  of  our  national  strength. 
The  sufferers  are  at  least  a  third  part  of  our 
population.  That  they  have  causes  of  dis- 
ease indolently  left  to  blight  them  and  their 
work  is  an  intolerable  wrong.  To  be  able  to 
redress  that  wrong  is  one  of  the  greatest 
opportunities  for  doing  good  that  human 
institutions  can  afford." — Sir  John  Simon, 
Medical  Officer,  Report  to  Privy  Council  of 
Great  Britain,  1861. 

"  We  do  not  wish  to  see  productive  energy 
sapped  by  excessive  toil  or  by  labor  under 
improper  conditions.  We  want  men  pro- 
tected from  avoidable  danger  to  life  and 
limb,  and  to  see  a  diminution  in  the  shock- 
ing number  of  preventable  casualties  in  our 
industrial  employments,  which  constitute  a 
disgrace  to  the  country. 

"  We  seek  the  dissemination  of  informa- 
tion with  regard  to  the  practical  conduct  of 
life,  so  as  to  remove  the  ills  which  are  due 
to  simple  ignorance." — Ex-Gov.  Charles  E. 
Hughes,  "  The  Social  Ideal."      ' 


Conservation  of  the  Living  Machine 

EFFICIENCY  is  the  dominant 
idea  in  modern  industry.  Ris- 
ing standards  of  living  and 
diminishing  natural  resources  make 
the  haphazard  methods  of  earlier  days 
more  and  more  inadequate.  Raw 
materials  are  carefully  conserved. 
Machinery  is  studied  and  simplified 
and  made  effective  in  the  minutest 
detail.  Special  foremen  are  employed 
to  superintend  the  distribution  of  work 
from  hand  to  hand  in  the  factory  so 
that  all  waste  of  time  and  energy  may 
be  minimized. 

One  side  of  the  problem  is  however 
still  strangely  neglected.  The  most 
important  machine  in  every  workshop 
is  the  living  machine.  In  the  cotton 
industry  in  1905  interest  on  the  ordinary 
money  capital  at  5  per  cent  would  have 
amounted  only  to  30  million  dollars 
against  96  millions  paid  out  in  wages, 
as  interest  on  the  life  capital  invested. 

There  is  no  other  machine  so  directly 
responsive  to  slight  changes  in  its  sur- 


roundings  as  the  human  body.  A  few 
degrees  change  in  temperature  make  a 
vast  difference  in  the  efficiency  of  the 
worker,  and  so  in  the  service  which 
the  employer  receives  for  his  wages, 
in  the  quantity  and  quality  of  work 
and  freedom  from  breakage  and  waste 
of  material. 

If  this  is  true  for  the  employer  it  is 
of  course  far  more  true  for  the  em- 
ployee. Not  only  his  efficiency,  which 
determines  his  earning  power,  but  his 
happiness  and  his  health,  perhaps  his 
life,  may  depend  on  the  conditions 
under  which  he  lives  during  his  work- 
ing hours.  Four  out  of  five  deaths  in 
certain  industries  are  due  to  industrial 
tuberculosis,  which  results  from  the 
breathing  of  irritating  dusts.  Yet  the 
operative  often  unites  with  the  factory 
owner  in  maintaining  conditions  which 
violate  every  principal  of  sanitation 
and  hygiene,  and  lay  upon  both  the 
burden  that  inefficiency  brings  in  its 
train.  It  is  not  heartless  cupidity  on 
the  one  hand  nor  willful  carelessness  on 
the  other.  It  is  simply  lack  of  knowl- 
edge of  what  is  going  on. 


The  Waste  of  Life  on  the  Railroad, 
in  the  Mine  and  in  the  Shop 

One  of  the  most  obvious  and  striking! 
preventable  wastes   is  that  due  to   in-[ 
dustrial  accidents  on  railroads,  in  mines 
and   in  factories.     About  10,000  per- 
sons are  killed   and   100,000  more  or| 
less  seriously   injured  on  the  railways 
of  the  United  States  every  year.     Some 
3,000  fatal  accidents  occur  annually  in 
the  course  of  mining  operations,  and| 
probably  5,000  deaths  result  from  ac- 
cidents in  the  operation  of  machinery 
in  factory  and  workshop. 

Much  of  the  suffering  and  misery 
represented  by  these  bald  figures  is  pre- 
ventable,— is  prevented  in  other  coun- 
tries. Fatalities  are  four  times  as 
common  among  our  railroad  employees 
as  among  those  of  England,  and  other 
accidents  seven  times  as  frequent. 
Coal  mining  was  nearly  as  fatal  in 
Belgium  between  1830  and  1840  as  it 
is  in  the  United  States  to-day,  but  the 
Belgians  have  cut  their  death  rate 
down  to  less  than  one  third  of  what  it 
was. 


Preventable  Industrial  Accidents 

The  responsibility  for  these  condi- 
tions rests  upon  both  parties  to  the  in- 
dustrial partnership, — upon  employer 
and  employee  alike.  Everyone  who 
examines  the  problem  with  an  open 
mind  knows  that  few  railroad  officials 
and  factory  managers  have  done  all  that 
they  might  to  provide  safety  appliances 
and  to  frame  and  enforce  regulations 
against  the  dangers  of  the  occupations 
for  which  they  are  responsible.  Every- 
one knows  that  in  mining  and  in  man- 
ufacturing many  accidents  arise  directly 
from  the  employment  of  children  and 
ignorant  persons  at  tasks  for  which 
they  are  manifestly  not  equipped.  On 
the  other  hand  it  is  equally  clear  that 
the  employee  frequently  displays  a 
reckless  carelessness  and  a  readiness  to 
take  chances  which  are  so  common  in 
this  country  as  to  be  almost  a  national 
characteristic. 

At  times,  notably  in  railroading,  the 
resources  of  labor  organizations  have 
been  vigorously  and  successfully  em- 
ployed to  thwart  the  enforcement  of 
rules  which   were   more   beneficial   to 


them  than  to  either  their  employers 
or  the  public.  In  Crystal  Eastman's 
admirable  study  of  work  accidents  in 
Pittsburg  it  appeared  that  out  of  410 
fatal  accidents,  the  victim  or  his  fellow- 
workers  were  responsible  in  188  cases 
and  the  employer  in  147  cases. 

The  phrase  "Life  is  cheap,"  is  worse 
than  cynical,  it  is  foolish.  Aside  from 
the  moral  issues  involved  in  human 
suffering  all  waste  must  be  paid  for. 
Is  it  not  time  that  the  employers  of 
America  set  themselves  to  remedy  a 
condition  that  Governor  Hughes  rightly 
called  a  national  disgrace  by  providing 
the  safeguards  that  are  now  available, — 
the  guards  for  belts  and  saws  and  re- 
volving parts,  such  as  are  to  be  seen 
in  the  American  Museum  of  Safety 
Devices  in  New  York? 

Is  it  not  time  that  the  workers  of 
America  addressed  themselves  seriously 
to  their  part  of  the  problem  and  moved 
actively  through  their  unions  for  the 
enforcement  of  a  new  standard  of  con- 
scientious co-operation  in  the  task  of 
freeing  their  crafts  from  the  prevent- 
able dangers  that  attend  them? 


The  Inevitable,  Residual   Burden   of 
Industrial  Accidents 

A  large  proportion  of  the  injuries 
and  deaths  in  railroading,  mining  and 
factory  work  could  be  prevented  by 
the  installation  of  safety  devices  and 
by  proper  care  on  the  part  of  the  oper- 
ative. On  the  other  hand  a  certain 
risk  is  essential  to  many  employments. 
You  cannot  mine  coal  or  make  steel 
or  operate  railroads  without  a  sacrifice 
of  human  lives.  There  is  a  noble 
saying  over  the  door  of  the  Sailors' 
Home  at  Lubeck,  "It  is  necessary  to 
sail  the  seas.  It  is  not  necessary  to 
live."  After  all  preventable  risks 
have  been  minimized  there  must  remain 
the  stern  fact  that  service  means  de- 
votion,— even  at  times,  of  life  itself. 
There  is  a  note  of  high  and  unsuspected 
heroism  underlying  the  most  prosaic 
of  modern  industries. 

It  is  important  that  the  risk  of  in- 
evitable accident  should  be  recognized 
and  appreciated  and  placed  where  it 
belongs.  It  is  as  much  a  necessity  of 
production  as  the  wearing  out  of 
machinery,  and  like  the  wearing  out 
of  machinery  that  part  of  it  which  can 


be  repaired — the  money  loss — should 
be  charged  against  the  industry  itself 
and  paid  by  the  purchasers  of  the 
product. 

Our  American  system  of  the  past 
was  as  far  as  possible  from  accom- 
plishing this  end.  The  maimed  em- 
ployee or  the  widow  of  the  fatally 
injured  received  no  compensation  at 
all  unless  legal  proceedings  were  in- 
stituted in  each  special  case,  and  then 
not  unless  it  could  be  proved  that  the 
employer  had  been  guilty  of  special 
negligence,  the  employee  being  held 
to  assume  all  the  ordinary  risks  of  the 
employment  and  those  due  to  the  negli- 
gence   of    any    other    fellow-servants. 

The  practical  result  has  been  that  on 
the  one  hand  large  expenditures  have 
been  made  by  employers  for  insurance 
and  for  the  legal  expense  of  contesting 
lawsuits,  and  that  on  the  other  hand 
a  few  employees  with  financial  re- 
sources and  acute  legal  assistance  have 
mulcted  their  employers,  while  the 
great  mass  of  the  needy  sufferers  have 
received  nothing  or  almost  nothing. 
Thus  in  the  study  of  work  accidents 
at   Pittsburg  it   appeared   that   of   235 


married  employees  killed,  59  received 
nothing,  65  received  $100  or  less,  and 
40  between  $100  and  $500.  The  bur- 
den of  necessary  accidents  therefor  falls 
under  this  system, — first  upon  the 
family  of  the  innocent  victim  and  then 
upon  the  community  at  large  whose 
charitable  agencies  must  be  called  in 
to  furnish  relief. 

"Workmen's  Compensation   Laws 

The  rational  method  of  dealing  with 
inevitable  work  accidents  has  been 
worked  out  successfully  in  all  the 
principal  European  countries,  and  con- 
sists in  a  system  of  Workmen's  Com- 
pensation, by  which  the  victim  of 
industrial  accidents,  except  when  caused 
by  his  own  clear  neglect,  is  entitled 
by  right  and  without  legal  proceedings, 
to  a  proper  money  equivalent  for  the 
injury  received.  Steps  have  recently 
been  taken  for  the  introduction  of  such 
a  system  in  this  country  along  two 
distinct  lines,  by  the  voluntary  initia- 
tive of  manufacturers  and  by  legal 
enactment. 

The  United  States  Steel  Corpora- 
tion, the  International  Harvester  Com- 


pany  and  other  employers  of  labor  have 
introduced  of  their  own  accord  plans 
by  which  their  employees  may  receive 
automatic  compensation;  and  in  New 
York  and  Montana  and  Maryland  laws 
were  passed  in  1910  making  such  an 
arrangement  optional  or  compulsory 
for  certain  classes  of  occupations. 

In  1911,  ten  different  states,  Cali- 
fornia, Illinois,  Kansas,  Massachu- 
setts, Nevada,  New  Hampshire,  New 
Jersey,  Ohio,  Washington  and  Wis- 
consin, have  already  enacted  laws  bear- 
ing on  this  subject. 

The  movement  for  compulsory  com- 
pensation has  been  temporarily  checked 
by  the  decision  that  the  New  York  law 
of  1910  was  unconstitutional,  but  busi- 
ness men,  labor  leaders  and  economists 
are  united  in  the  conviction  that  in 
some  way  the  system  of  Employers' 
Liability  must  be  introduced  in  order 
that  the  burden  of  inevitable  industrial 
accidents  may  be  placed  where  it 
justly  belongs. 

Industrial  Poisons 

There  are  other  classes  of  industrial 
dangers    less    obvious    than  mine  ex- 


io 


plosions  and  railroad  accidents,  but 
none  the  less  serious  for  those  exposed 
to  them.  If  a  pound  of  lead  drops  on 
a  workman's  head  the  catastrophe  is 
more  obvious  than  if  minute  quantities 
of  lead  salts  are  taken  into  the  system 
day  by  day,  but  the  poisoning  is  as 
fatal  as  the  accident,  although  only 
the  medical  man  may  perceive  what  is 
going  on. 

Dr.  Hamilton  of  the  Illinois  Com- 
mission on  Occupational  Diseases  was 
able  to  discover  578  cases  of  lead 
poisoning  occurring  in  three  years  in 
the  state  of  Illinois  alone.  The  white 
lead  industry,  lead  smelting  and  re- 
fining, the  making  of  storage  batteries, 
the  making  of  dry  colors  and  paints 
and  the  painting  trade  were  the  five 
principal  industries  affected,  but  occa- 
sional poisoning  occurred  in  many 
other  crafts. 

The  victim,  after  a  period  of  general 
disturbance,  headache,  loss  of  appetite, 
etc.,  is  usually  seized  by  an  acute 
attack  of  colic,  "painter's  colic,"  as 
it  is  rightly  called.  If  he  continues 
at  work  and  adds  day  by  day  to  the 
stock    of    poison    in    his    system,    by 


ii 


breathing  lead  dust  or  by  getting 
small  particles  of  it  into  his  mouth 
with  his  fingers  or  on  his  food,  the 
condition  becomes  chronic.  Gradually 
the  whole  system  is  poisoned,  and  death 
results  from  the  injury  to  some  vital 
organ ;  or  acute  nervous  symptoms 
may  set  in,  paralysis  of  local  muscles, 
" wrist  drop, "  so-called,  or  epilepsy 
and  insanity. 

John  B.  Andrews  in  Bulletin  86  of 
the  United  States  Bureau  of  Labor  re- 
ports that  65  per  cent  of  the  employees 
in  American  match  factories  are  work- 
ing under  conditions  which  expose  them 
to  the  fumes  of  phosphorus  and  the 
danger  of  "phossy"  jaw,  a  loathsome 
disease  in  which  the  bones  of  the  jaw 
ulcerate  and  are  gradually  eaten  away. 
The  New  York  and  New  Jersey  sec- 
tion of  the  National  Civic  Federation 
in  three  months'  time  found  60  cases  of 
mercurial  poisoning,  a  nervous  disease 
called  in  the  trade  "the  shakes, ' '  among 
the  hat  makers  of  Brooklyn,  Newark 
and  Orange  as  a  result  of  their  poison- 
ing by  the  mercury  salts  used  in  pre- 
paring felt. 

Thirty  other   industrial   poisons   are 


12 


listed  in  a  recent  German  report,  of 
which  most  are  less  deadly,  but  some 
like  benzine  and  wood  alcohol  are  per- 
haps even  more  serious  because  of  the 
large  number  of  operatives  exposed  to 
their  effect. 

Prevention  of  Industrial  Poisoning 

All  these  industrial  poisonings  are 
preventable, — are  largely  prevented, — 
by  other  nations.  Fumes  can  be  drawn 
off  by  special  ventilation,  and  the  in- 
troduction of  the  poison  by  the  mouth 
can  be  forestalled  by  cleanliness,  the 
separation  of  workrooms  and  lunch 
rooms,  washing  of  hands  and  change 
of  clothes  on  leaving  the  workroom. 
In  many  instances  less  poisonous  sub- 
stitutes can  be  introduced,  as  in  the  case 
of  matchmaking. 

The  use  of  white  phosphorus  (the 
poisonous  kind)  is  forbidden  by  law  in 
France,  Denmark,  Italy,  Germany, 
Great  Britain  and  several  other  Euro- 
pean countries;  and  a  law  having  the 
same  effect  has  been  introduced  in  our 
own  Congress. 

The  use  of  poisonous  lead  com- 
pounds is  still  permitted,  but  in  Eng- 


l3 


land  and  Germany  is  so  hedged  about 
with  stringent  regulations  as  to  be 
robbed  of  its  worst  dangers.  Large 
English  white  lead  factories  under  the 
most  careful  supervision  frequently 
show  not  a  case  of  lead  poisoning  for 
several  successive  years,  while  Dr. 
Hamilton  found  25  cases  during  one 
year  in  a  ''model"  Illinois  factory  em- 
ploying 200  hands. 

Strict  sanitary  regulations  and  regu- 
lar medical  inspection  must  be  intro- 
duced in  American  trades  exposed  to 
such  poisons  if  the  employees  are  to 
be  protected  against  these  unnecessary 
dangers. 

Tuberculosis  in  the  Dusty  Trades 

There  is  another  problem  more  seri- 
ous still, — one  which  is  perhaps  indeed 
the  central  problem  of  factory  sanita- 
tion,— that  of  industrial  tuberculosis. 
The  trades  exposed  to  lead  and  phos- 
phorus and  other  acute  poisons  are 
small  ones,  and,  serious  as  the  danger  is 
for  those  exposed,  the  death  roll  is  not 
a  long  one.  On  the  other  hand  the 
bad  air  and  the  dust  to  which  the 
workers   in  many   of   our   greatest   in- 


dustries  are  exposed  work  their  insid- 
ious effects  upon  hundreds  of  thou- 
sands. 

Tuberculosis  is  pre-eminently  a 
social  and  an  industrial  disease,  for 
the  reason  that  it  is  a  disease  due  to 
bad  living  and  working  conditions,  to 
insanitary  tenements  and  workrooms. 
Two  factors  must  contribute  to  every 
case  of  consumption, — the  germ  and  a 
lowered  vitality  on  the  part  of  the 
patient.  Preventive  measures  must 
therefor  follow  two  lines,  the  care  of 
sputum  of  the  consumptive,  which  is 
the  chief  agent  for  the  distribution  of 
the  germ,  and  the  maintenance  of  con- 
ditions which  will  keep  those  not  seri- 
ously infected  in  condition  to  resist  the 
ravages  of  the  occasional  germs  which 
are  sure  sooner  or  later  to  gain  an  en- 
trance. 

The  normal  body  has  its  "fighting 
edge"  and  can  protect  itself  against 
the  tubercle  bacillus  if  given  a  fair 
chance,  but  the  lung  tissue  which 
is  lacerated  by  sharp  particles  of 
granite  or  steel  quickly  succumbs  to 
the  bacterial  invader. 

In  dusty  trades,  like  stonecutting  and 


i5 


cutlery  working  and  emery  grinding, 
75  per  cent  of  all  the  deaths  among 
operatives  is  often  due  to  tuberculosis, 
against  25  per  cent  for  the  normal 
adult  population.  This  may  be  fairly 
interpreted  as  meaning  that  the  actual 
death  rate  from  tuberculosis  in  these 
trades  is  from  two  to  four  times  as  high 
as  in  a  corresponding  average  popula- 
tion;  in  other  words,  three  or  four  or 
five  out  of  a  thousand  of  these  workers 
are  sacrificed  every  year  to  the  condi- 
tions under  which  they  labor. 

In  other  industries  where  there  is  less 
dust,  or  softer  less  irritant  dust  of  ani- 
mal or  vegetable  origin,  the  damage  is 
less  serious,  but  is  nevertheless  real  and 
important.  The  investigation  made 
by  the  Massachusetts  State  Board  of 
Health  in  1907  showed  that  of  4,399 
dust-producing  machines  in  shoe  fac- 
tories 2, 769  were  not  properly  equipped 
with  devices  for  dust  removal.  Such 
conditions  exist  in  very  many  of  the 
large  and  small  industries  of  this 
country;  and  though  the  total  resulting 
cost  in  life  and  health  is  impossible  to 
estimate  with  any  accuracy  it  is  un- 
questionably a  very  large  one. 

16 


Protection  of  the  "Worker  from 
Harmful  Dusts 

This  damage  like  that  which  results 
from  accidents  and  poisonings  is  in 
large  degree  preventable.  There  are 
three  principal  methods  of  dealing 
with  it.  In  the  first  place  there  are 
some  industries  in  which  the  original 
discharge  of  dust  into  the  air  may  be 
prevented  without  any  serious  impair- 
ment of  efficiency. 

Wet  grinding  for  example  may  be 
substituted  for  dry,  or  the  process  which 
evolves  dust  may  be  carried  on  in  a 
closed  vessel  as  is  done  in  certain  of 
the  newer  lead  factories.  Secondly, 
where  the  formation  of  dust  is  essential 
it  can  usually  be  removed  and  the 
worker  protected  from  its  effects  by 
the  installation  of  hoods  equipped  with 
ducts  and  fans  by  which  the  dusty  air 
may  be  drawn  away  from  the  part  of 
the  machine  where  it  is  formed.  The 
provision  of  such  a  device  is  required 
by  law  in  many  states,  but  the  require- 
ments are  general  and  as  a  rule  inade- 
quately enforced. 

It  is  morally  the  duty  of  every  em- 
ployer who   maintains   emery  wheels, 

17 


buffing  wheels  or  any  other  dust  pro- 
ducing device  to  see  that  they  are 
equipped  not  merely  with  hoods  and 
suction  but  with  hoods  and  suction 
adequate  to  secure  real  protection 
against  the  dangers  to  which  his  work- 
men are  unknowingly  exposed. 

Respirators 

Finally,  in  certain  trades,  the  elim- 
ination of  dangerous  dusts  is  practi- 
cally impossible.  This  is  true  in  some 
processes  of  granite  working.  In  such 
cases  there  remains  only  one  remedy, 
the  wearing  of  respirators  of  some 
efficient  type  which  will  keep  the  dust 
surrounding  the  worker  out  of  his  nose 
and  throat  and  lungs.  Respirators  are 
uncomfortable  and  annoying;  and  here 
comes  in  the  worker's  responsibility 
for  industrial  disease. 

Often  he  refuses  to  protect  himself 
in  this  way,  and  even  in  the  case  of  the 
suction  device  which  guards  him  from 
the  dust  of  grinding  wheels  he  fre- 
quently removes  the  hood  if  it  be  de- 
tachable in  order  that  he  may  work  a 
little  more  conveniently.  In  these  pre- 
cautions and  in  the  prevention  of  pro- 

iS 


miscuous  spitting  which  spreads  the 
germs  the  employee  must  do  his  part 
if  the  burden  of  needless  industrial 
disease  is  ever  to  be  lifted. 

Air  Conditioning'  for  the  Living 
Machine 

Even  dust  is  perhaps  less  important 
as  a  menace  to  the  health  and  effi- 
ciency of  the  worker  than  the  over- 
heating and  under-ventilation  which  is 
so  general  in  factories  and  workshops 
of  all  kinds,  and  which  though  far  less 
immediately  serious  in  its  action  grad- 
ually undermines  the  strength  and 
vigor  of  the  whole  industrial  army. 
There  is  no  single  factor  which  so 
directly  and  strikingly  affects  the  tone 
of  the  human  body  as  the  physical  con- 
dition of  the  atmospheric  ocean  in 
which  it  is  bathed. 

The  contrast  between  one's  feelings 
and  one's  effectiveness  on  a  close,  hot, 
muggy  day  in  August  and  on  a  cool, 
brisk,  bright  October  morning  is  suffi- 
ciently obvious,  yet  many  a  factory 
operative  is  kept  at  the  August  level 
by  an  August  atmosphere  all  through 
the  winter    months.     He    works    list- 


19 


lessly,  he  half  accomplishes  his  task, 
he  breaks  and  wastes  the  property  and 
the  material  entrusted  to  his  care.  At 
the  close  of  the  day  he  passes  from 
the  overcrowded,  overheated  workroom 
into  the  chill  night  air,  and  with 
lowered  vitality  falls  a  prey  to  minor 
illness,  colds  and  influenzas,  if  not  to 
the  great  enemy,  tuberculosis,  always 
lurking  in  the  background. 

The  Danger  of  Overheated  Air 

Sanitary  opinion  in  regard  to  air 
supply  has  made  great  advances  in 
recent  years, — notably  in  the  recogni- 
tion that  it  is  no  mysterious  poison  that 
makes  bad  air  harmful  but  rather  its 
physical  condition  in  regard  to  tem- 
perature and  humidity.*  The  chief 
thing  that  produces  discomfort  and 
danger  in  an  ill-ventilated  room  is  the 
fact  that  the  air  has  become  overheated 
and  either  too  moist  or  too  dry. 

The  human  body  is  adapted  to  a 
temperature  of  68°  to  70°  and  a  relative 
humidity  of  60-70  per  cent,  and  great 
deviation  from  these  limits  means  an 
inevitable    deterioration    in    efficiency 


20 


and  a  lowering  of  health  tone  that 
makes  it  a  prey  for  any  sort  of  disease.* 
In  particular  a  rise  of  the  thermometer 
over  70°  should  never  be  permitted  ex- 
cept when  the  outdoor  temperature  is 
above  this  limit;  and  a  superintendent 
who  does  not  keep  a  thermometer  in 
every  workroom  and  see  that  it  is  kept 
below  70°  is  unconsciously  neglecting 
his  own  interests  as  clearly  as  if  he 
permitted  his  lifeless  machines  to  run 
in  such  a  way  as  to  rack  themselves 
to  pieces. 

How  to  Secure  Fresh  Air 

In  small  workrooms  which  are  not 
overcrowded,  proper  air  conditions 
may  be  maintained  without  special 
ventilation  by  the  intelligent  use  of 
doors  and  windows.  Hot  vitiated  air 
tends  to  rise,  and  the  Hygienic  Window 
is  one  which  is  open  a  little  at  the  top 


*The  relative  humidity  or  moistness  of  the  air  is 
best  measured  by  the  use  of  a  wet  and  dry  bulb  ther- 
mometer. The  temperature  of  the  thermometer  whose 
bulb  is  kept  moist  by  a  saturated  cloth  is  lowered  by 
evaporation  which  is  more  rapid  the  drier  the  air.  The 
best  form  of  wet  and  dry  bulb  thermometer  is  the  Sling 
Psychrometer  described  in  Bulletin  235  of  the  United 
States  Weather  Bureau,  and  both  this  and  a  simpler 
and  fairly  accurate  instrument,  the  Hygrodeike,  may 
be  bought  of  any  instrument  maker. 


21 


to  allow  the  exit  of  foul  air  and  open 
a  little  at  the  bottom  to  permit  the  en- 
trance of  a  fresh  supply.  Even  strong 
draughts  are  less  harmful  than  is  com- 
monly supposed  and  everyone  is  more 
comfortable  if  the  heat  and  the  odors 
which  the  body  gives  off  are  swept 
away  by  moderate  steady  currents. 

A  screen  of  copper  wire  may  be  made 
to  fit  into  the  lower  window  opening  in 
order  to  prevent  excessive  draughts, 
and  in  cold  weather  perhaps  re-enforced 
by  covering  it  with  cloth.  At  the 
lunch  hour  and  before  and  after  hours 
every  workroom  should  be  thoroughly 
flushed  out  and  cleansed  by  throwing 
open  all  the  windows  available. 

With  large  and  crowded  workrooms 
special  ventilation  must  be  provided 
by  means  of  ducts  and  fans.  In  the 
design  of  such  systems  care  should  be 
taken  to  secure  efficient  distribution  of 
air  to  all  parts  of  the  room.  A  factory 
is  not  a  simple  box  in  which  air  will 
automatically  distribute  itself  if  only 
the  requisite  supply  is  forced  into  it 
at  one  or  a  few  isolated  points. 

Furthermore    a    ventilating    system 


22 


must  be  intelligently  operated  as  well 
as  scientifically  installed.  The  air 
which  is  supplied  must  be  of  the 
proper  temperature  and  humidity,  and 
if  the  engineer  in  charge  of  the  system 
cannot  give  skilled  attention  to  such 
details  disappointment  is  almost  cer- 
tain to  ensue. 

The  Economic  Value  of  Factory 
Ventilation 

All  these  provisions  cost  money  and 
require  care  in  construction  and  in 
maintenance.  For  a  large  establish- 
ment where  such  special  ventilation  is 
required  there  is  however  little  doubt 
that  the  time  and  money  spent  will 
bring  a  direct  return  in  increased  effi- 
ciency of  production.  There  is  plenty 
of  evidence  that  such  has  often  been 
the  case. 

The  ventilation  of  the  United  States 
Pension  Bureau  reduced  the  days  of 
absence  of  employees  from  illness  by 
46  per  cent.  The  installation  of  a 
simple  ventilating  system  in  the  Cam- 
bridge telephone  toll  room  cut  the 
winter  absences  by  58  per  cent. 


23 


Mr.  D.  D.  Kimball,  in  a  recent  arti- 
cle, quotes  Townsend  Grace  Company 
as  claiming  that  a  ventilating  system 
in  their  straw  hat  factory  paid  for  itself 
in  one  year;  and  he  cites  a  printing 
establishment  in  New  York  in  which 
"a  ventilation  system  was  installed 
because  of  the  insistence  of  the  State 
Department  of  Labor  that  the  law  be 
complied  with,  the  order  having  been 
resisted  for  two  years. 

After  the  system  had  been  in  use  a 
year  the  proprietor  said  that  had  he 
known  in  advance  of  the  results  to  be 
obtained  no  order  would  have  been 
necessary  to  have  brought  about  the 
installation.  Whereas  formerly  the 
men  had  left  work  on  busy  days  in  an 
exhausted  condition,  and  sickness  was 
common,  now  the  men  left  work  on  all 
days  in  an  entirely  different  condition, 
and  sickness  had  been  very  much  re- 
duced. The  errors  in  typesetting  and 
time  required  for  making  corrections 
were  greatly  reduced. " 

Eye  Fatigue  and  Eye  Strain 

Another  point  in  which  there  is 
ample   opportunity    for   practical    im- 

24 


provements  beneficial  to  employer  and 
employee  alike  is  in  respect  to  the 
lighting  of  factories  and  workrooms. 
The  Massachusetts  State  Board  of 
Health  in  the  report  to  which  refer- 
ence has  been  made  points   out  that: 

"It  is  a  well-established  fact  that 
either  the  over-use  of  the  eyes,  or  the 
use  of  eyes  under  bad  conditions,  may 
give  rise  to  eye  fatigue  or  to  eye 
strain;  and  many  eye  specialists  be- 
lieve that  at  least  80  to  90  per  cent  of 
headaches  are  dependent  on  eye  strain. 

With  these  facts  in  mind  it  is  im- 
possible to  ignore  the  probability  that 
many  individuals  working  by  gaslight, 
or  even  electric  light,  in  dirty,  un- 
painted,  overheated  rooms,  with  im- 
pure air  and  excessive  moisture,  for 
ten  hours  a  day,  or  merely  for  the  last 
two  hours  during  the  day,  use  up  a 
great  deal  of  nervous  energy  and  suffer 
from  eye  fatigue  or  eye  strain,  and  its 
consequences."  The  danger  from 
accidents  is  also  undoubtedly  increased 
by  eye  strain,  defective  vision  and  dim 
light. 

Yet  the  Massachusetts  Board  found 
that  little  thought  had  been  given   in 


25 


mill  construction,  particularly  in  the 
textile  industry,  to  providing  proper 
lighting  for  the  work  to  be  done. 
Many  rooms  were  of  old  construction, 
with  low  ceilings,  small  windows  and 
small  panes  of  glass.  In  the  middle 
of  large  rooms  and  in  basements  con- 
ditions were  particularly  bad. 

Aside  from  structural  defects,  too, 
the  failure  to  keep  walls  and  ceiling 
clear  and  white  and  the  infrequent 
washing  of  the  windows  contribute  in 
large  degree  to  make  lighting  inade- 
quate and  harmful.  Where  artificial 
light  is  provided  it  may  frequently  be 
wrongly  placed  so  that  the  workbench 
is  insufficiently  illuminated  or,  what  is 
quite  as  bad,  so  that  a  direct  glare  is 
thrown  into  the  worker's  eyes. 

The  Physical  Condition  of  the  Worker 

So  far  reference  has  been  made 
chiefly  to  the  environment  of  the 
worker,  to  the  light  and  air  which 
surround  him  and  affect  his  activities, 
to  the  poisons  and  dust  and  dangerous 
machinery  which  may  work  injury  to 
him.     There  is  another  factor  to  be  con- 


26 


sidered  however, — the  living  worker 
himself  and  his  varying  conditions  of 
health  and  disease  which  interact  with 
the  external  world  about  him. 

Special  foremen  are  provided  to  in- 
spect machines,  to  replace  worn  parts, 
to  regulate  speed  with  painstaking 
care.  As  a  rule  there  is  no  depart- 
ment to  care  for  the  men  who  run  the 
machines,  the  human  factor  in  pro- 
duction. Yet  in  some  cases  the  em- 
ployer may  well  go  beyond  the  pro- 
vision of  sanitary  surroundings  and 
concern  himself  directly  with  the  phys- 
ical condition  of  the  worker  himself. 

Medical  Supervision 

In  highly  dangerous  occupations 
like  those  which  involve  exposure  to 
lead  or  other  acute  poisons  medical 
supervision  of  the  employee  is  almost 
imperative.  In  England  it  is  required 
that  men  who  are  to  work  with  dan- 
gerous lead  compounds  must  be  exam- 
ined before  doing  so  in  order  that  it 
may  be  certain  they  are  in  good  enough 
condition  to  warrant  the  risk,  and  they 
must  be  periodically  examined  during 


27 


the  period  of  their  employment  in 
order  that  if  disease  develops  it  may 
be  detected  in  its  early  stages  before  it 
is  too  late.  The  Massachusetts  law- 
makes  a  similar  provision  for  minors 
employed  in  factory  work. 

In  establishments  like  the  American 
Steel  and  Wire  Company  and  the 
Cleveland  Hardware  Company,  where 
much  dangerous  machinery  must  be 
used,  emergency  rooms  are  equipped 
for  the  prompt  treatment  of  minor  in- 
juries ;  and  they  have  more  than  proved 
their  worth  in  preventing  slight  acci- 
dents from  developing  into  serious  dis- 
abilities. 

Certain  large  industrial  plants  have 
gone  farther  still,  and  have  engaged 
nurses  or  doctors  to  be  regularly  at  the 
factory  for  consultation  and  to  visit 
employees  who  desire  it  in  their  homes 
and  there  give  them  free  medical  care. 

Of  such  a  plan  for  a  visiting  nurse 
as  worked  out  by  the  Waltham  Watch 
Company  it  was  stated:  "It  is  almost 
impossible  to  estimate  the  ground 
which  has  been  gained  in  preventing 
absences    from    work,    prevention    of 


28 


contagion  and  infection,  especially  at 
times  when  there  is  a  prevalence  of 
disease  or  possibly  a  threatened  epi- 
demic. " 


Overstraining   and  Overspeedingf    of 
the  Human  Machine 

There  is  still  one  more  problem 
which  deserves  brief  notice  in  any  con- 
sideration of  the  factors  which  affect 
the  health  and  comfort  and  productiv- 
ity of  the  worker.  Work  that  is  too 
severe  or  too  long  continued  for  the 
strength  gradually  saps  the  vitality  and 
brings  sickness  and  suffering  and  in- 
capacity in  its  train  as  surely  as  the 
factory  conditions  which  produce  lead 
poisoning   or   industrial    tuberculosis. 

The  operative  is  as  easily  injured 
by  overspeeding  as  the  most  delicate 
machine,  and  prolonged  effort  leading 
to  undue  accumulation  of  the  so-called 
1  'toxin  of  fatigue,"  gradually  under- 
mines the  strength  and  vigor  of  the 
strongest. 

The  legal  regulation  of  hours  of 
labor  and  of  the  conditions  under 
which  women  and  minors  may  work  in 


29 


various  industries  is  a  complex  prob- 
lem with  its  social  and  economic  as 
well  as  its  physiological  and  humani- 
tarian sides.  Rash  and  ill-advised 
interference  with  the  inter-relations  of 
society  may  do  more  harm  than  good. 
Yet  it  is  clear  that  labor  which  works 
permanent  damage  to  the  worker  is 
harmful  to  all  parties  concerned. 

Life  capital  must  not  be  wan- 
tonly wasted  if  industrial  leadership 
is  to  be  maintained;  and,  in  par- 
ticular, working  conditions  which  are 
injurious  to  women  and  children  must 
be  controlled,  for  on  the  next  genera- 
tion the  future  of  the  nation  must 
depend. 

Welfare  Work  a  Separate  Problem 

It  should  be  recognized  quite  clearly 
that  such  sanitary  and  medical  provi- 
sions as  have  been  discussed  bear  no 
necessary  relation  to  the  sort  of  semi- 
philanthropic  effort  which  has  come  to 
be  known  as  Welfare  Work.  In  mak- 
ing provision  for  the  safety  and  com- 
fort of  his  operatives  an  employer  may 
recognize  one  or  all  of  three  distinct 
motives. 

30 


In  the  first  place  working  conditions 
in  harmony  with  safety  and  healthful- 
ness  are  due  to  the  employee  on  the 
ground  of  simple  right  and  justice. 
It  is  clearly  unfair  that  preventable 
dangers  should  be  allowed  to  kill  and 
maim  and  invalid  the  worker  without 
his  fault  and  in  the  course  of  his 
necessary  daily  toil.  Most  of  the 
problems  which  have  been  considered 
belong  in  this  class,  and  the  employer 
need  only  be  actuated  by  a  sense  of 
common  justice  in  dealing  with  them. 

In  the  second  place  an  employer 
may  do  more  for  his  workers  than  they 
can  demand  of  right,  from  a  motive  of 
intelligent  self-interest.  This  impulse 
and  that  of  justice  combine  to  inspire 
improvements  in  light  and  ventilation 
which  bring  direct  return  in  the  pro- 
ductivity of  the  worker.  The  estab- 
lishment of  d  i  sp  ens  ar  i  es  and  the 
employment  of  doctors  and  visiting 
nurses  is  not  a  response  to  any  inherent 
right  of  the  worker;  but  in  certain 
cases  it  has  proved  so  advantageous  to 
the  employer  as  to  be  justified  on  broad 
business  grounds. 


3i 


Finally,  in  the  third  place,  some 
factory  owners  have  gone  beyond  the 
demands  either  of  justice  or  of  direct 
self-interest,  and  have  embarked  on 
undertakings  which  can  only  be  re- 
garded  as  philanthropic   in  character. 

The  establishment  of  libraries,  edu- 
cational centers,  clubhouses  and  gym- 
nasia, the  conduct  of  picnics  and 
other  festivities,  the  foundation  of  sav- 
ings and  loan  associations,  and  the  con- 
struction of  homes,  model  villages, 
etc.,  are  beyond  the  scope  of  the  busi- 
ness itself  and  are  in  the  nature  of 
voluntary  benefactions  of  the  employer 
to  the  employee. 

An  Important  Distinction 

These  activities,  to  which  the  term 
Welfare  Work  properly  applies,  belong 
to  a  different  class  from  those  pre- 
viously considered.  Anything  which 
directly  promotes  the  conduct  of  the 
business  may  be  offered  by  the  em- 
ployer and  accepted  by  the  employee 
without  hesitation.  Favors  however 
can  only  be  given  and  taken  when  a 
spirit  of  real  sympathy  exists. 


3^ 


This  is  the  reason  why  Welfare  Work 
as  such  has  sometimes  been  a  success 
and  sometimes  a  disappointing  failure. 
When  gifts  are  bestowed  in  a  patron- 
izing spirit  or  in  order  to  cover  the 
denial  of  important  fundamental  rights 
they  are  not  likely  to  find  a  cordial 
response. 

The  worker  has  been  described  as  a 
living  machine.  He  is  a  machine  from 
the  standpoint  of  physiology;  but  in 
the  sphere  of  human  relation  he  is  not 
a  machine  but  a  human  being. 

He  has  a  right  to  be  consulted  as  to 
what  shall  be  done  for  him.  In  the 
matter  of  receiving  favors  he  must 
have  the  opportunity  to  accept  or  to 
decline  with  dignity  and  self-respect. 

Philanthropy  between  employer  and 
employee  may  or  may  not  be  a  good 
thing,  depending  on  the  spirit  in 
which  it  is  offered  and  the  tact  with 
which  it  is  carried  out.  The  measures 
which  directly  promote  the  safety  and 
health  and  effectiveness  of  the  worker 
by  ensuring  to  him  the  most  favorable 
conditions  under  which  to  labor, — 
these  measures  stand   on  a  wholly  dif- 


33 


ferent  basis  and  are  always  and  every- 
where justified  by  their  results. 

The  Common  Interests  of  Employer 
and  Employee 

In  certain  aspects  of  their  common 
work  employer  and  employee  inevitably 
find  themselves  in  a  position  of  an- 
tagonism. What  is  given  to  one  is 
taken  from  the  other.  The  controversy 
may  be  acrimonious  or  it  may  be  firm 
and  good  tempered;  but  it  is  there.  In 
the  matter  of  hygiene  and  sanitation 
however  there  is  no  conflict  of  interests. 

Sickness  and  inefficiency  help  no- 
body. It  is  just  so  much  taken  out 
of  the  sum  of  human  happiness  and 
prosperity, — a  burden  whose  load  is 
shifted  from  one  to  another  in  the 
complex  scheme  of  society  until  each 
one  bears  his  part.  In  preventing  the 
careless  and  ignorant  waste  of  health 
and  strength  the  mill  owner  and  the 
labor  leader  can  stand  shoulder  to 
shoulder  as  workers  for  their  common 
good. 


34 


Human  Engineering 

To  the  far-sighted  employer  human 
engineering  should  be  an  integral 
factor  in  his  business.  The  selec- 
tion of  workers  physically  adapted 
to  their  labor,  the  maintenance  of  the 
best  practical  conditions  for  its  prose- 
cution, the  elimination  of  all  possible 
dangers  and  the  proper  compensation 
for  those  risks  that  must  occur,  these 
are  as  essential  to  the  successful  conduct 
of  a  great  business  as  any  of  its  me- 
chanical or  financial  problems.  Along 
with  the  Finance  Department,  the 
Mechanical  Engineering  Department, 
the  Sales  Department  and  the  rest 
should  go  a  Department  of  Human 
Engineering;  and  if  it  be  conducted 
in  the  proper  spirit  so  as  to  invite  co- 
operation rather  than  distrust  and  hos- 
tility this  is  one  department  in  which 
the  intelligent  employee  will  be  every 
whit  as  actively  interested  as  the  men 
who  have  it  directly  in  their  charge. 

Is  it  too  much  to  hope  that  a  broad 
and  comprehensive  policy  in  regard  to 
these  common  problems  of  hygiene 
and  sanitation  might  so  bind  together 


35 


employer  and  employee  as  to  make  for 
mutual  comprehension  in  a  much 
wider  field?  Beyond  the  limits  of 
physical  efficiency  are  other  less  defi- 
nite but  fundamental  interests,  for 
after  all  industrialism  at  bottom  is  not 
a  class  struggle  but  a  part  of  the  fight 
all  mankind  is  making  against  the 
common  enemies  of  want  and  igno- 
rance and  disease. 

In  a  deep  and  a  real  sense  we  are  all 
shoulder  to  shoulder,  and  the  enemy 
is  not  so  much  human  selfishness  as 
human  ignorance  and  human  limited 
capacity.  It  has  been  well  said  that,* 
"If  a  company  can  be  prompted  and 
sustained  by  a  spirit  that  industry  can 
do  something  more  than  to  produce 
products  and  profits,  then  if  a  man 
falls  in  the  ranks  whether  he  is  a 
private  or  a  general  he  has  fallen  in 
a  cause  that  is  worth  while." 

*Mr.  E.  A.  Bancroft,  International  Harvester  Co 


36 


HEALTH  AXIOMS  AND  MAXIMS 
FOR  THE  WORKER 

Compiled  by  the  Secretary,  Health-Edu- 
cation League* 

My  people  are  destroyed  for  lack  of  knowledge. 
— Hosea  iv.  6. 

"  A  law  of  Nature  is  as  sacred  as  a 
moral  principle." — Louis  Agassiz. 

"  The  conservation  of  our  national 
resources  is  only  preliminary  tt)  the 
larger  question  of  national  efficiency. " 
—  Theodore  Roosevelt. 

"Nothing  too  much." — Aristotle. 

u  If  pure  air  could  be  breathed  in 
factories,  stores,  houses — including  bed- 
rooms— it  is  probable  that  one  half  of 
the  hospitals  could  be  closed  and  one 
half  of  the  world's  diseases  could  be 
prevented." — Ellen  H.  Richards. 

u  Windows  were  made  to  be 
opened." — Florence  Nightingale. 

"  The  preservation  of  health  depends 
in  great  part  upon  food  well  cooked 
and  carefully  eaten.' ' — Dr.  William 
Osier. 

"  When  and  how  is  often  more  im- 
portant than  what  one  eats.  Do  not 
sat  when  very  tired  or  worried  or 
angry. 

37 


"  A  good  joke  or  laugh  is  often  better 
than  a  pill  to  aid  digestion." — Dr.  H. 
Sterling  Pomeroy. 

"It  is  quite  probable  that  half  or  two 
thirds  of  the  food  we  now  eat,  if  prop- 
erly cooked  and  thoroughly  chewed, 
would  serve  us  amply." — Ellen  H. 
Richards. 

"Many  dig  their  graves  with  their 
teeth." 

44  Keep  the  sewers  of  the  body  open. 
There  should  be  one  good  free  move- 
ment of  the  bowels  regularly  every 
day." 

"  Sleep  as  much  as  you  can, — never 
mind  about  the  old  proverbs, — and 
always  in  pure,  fresh  air.  Get  up,  if 
possible,  only  when  you  have  had  your 
sleep  out,  and  feel  rested.  To  wake 
growing  boys  and  girls  out  of  their  un- 
finished sleep  is  harmful." 

44  Sunlight,  the  great  and  potent  de- 
stroyer of  disease  germs,  is  a  guardian 
angel  of  your  household." 

"A  reasonable  amount  of  work  is 
essential  to  physical  and  mental  health  ; 
but  overwork,  over-speeding,  fatigue 
beyond  a  certain  point,  whether  in  in- 

38 


I 


Pi; 


fle 


dustry  or  athletics,  are  poisoners  and 
wasters  of  life." 

"Play,  recreation,  is  almost  as  neces- 
sary for  right  living  as  work,  but  it 
must  be  wholesome,  neither  the  kind 
nor  the  pace  that  kills." 

"Even  the  moderate  use  of  intoxi- 
cants interferes  with  the  steadiness  and 
swiftness  of  nerve  action  and  reaction, 
and  increases  very  much  the  danger  of 
accidents." 

"  Habits  of  cleanliness  can  be  main- 
tained even  in  the  grime  of  work.  They 
mean  health  and  life.  Never  eat  or 
landle  food  without  first  thoroughly 
washing  your  hands. 

"FOREMEN:  Never  spit  on  the 
'actory  stairway  or  floor,  especially 
when  you  have  a  cold,  nor  allow  your 
nen  to  do  so.  Precept  and  example 
>n  your  part  will  greatly  help  to  pre- 
sent filthy,  unsanitary  spitting  and  the 
ipread  of  contagious  diseases." 

"The  use  of  the  promiscuous  drinking 
:up  in  shop  or  factory,  or  in  any  public 
)lace,  is  forbidden  by  law  in  many 
tates,  and  is  always  and  everywhere  a 
nenace  to  health." 


39 


44  Pain  is  usually  a  danger  signal  for 
some  violation  of  a  law  of  health. 

••  Do  not  drug  the  pain  to  silence — 
except  under  the  advice  of  a  good 
physician. 

11  Heed  the  warning.  Find  out  the 
cause  of  the  pain.  Take  the  path  of 
recovery  and  safety  in  season." 

"  Worry  is  a  foe  of  the  mind  and  of 
health. 

''There  are  things  that  can  be  helped, 
and  things  that  cannot  be  helped. 
Worry  is  useless  in  either  case. 

''''Just  so  far  as  you  can,  avoid  the 
causes  of  worry,  excess,  disease  and 
debt,  by  means  of  intelligent  thrift,  care 
and  moderation." 

44  Our  best  protection  against  diseases 
of  all  kinds  is  the  power  of  a  strong 
vital  resistance,  due  chiefly  to  the  white 
cells  of  the  blood. 

44  Anything  that  weakens  this  resist- 
ance, whether  it  be  excessive  alcohol, 
chilling,  exposure,  dust,  over-fatigue  or 
anything  else,  cripples  our  defense  and 
exposes  us  to  the  attacks  of  the  enemy." 


t""l< 


Health  -  Education    League 

8  BEACON  STREET,  Room  36  ::   ::   BOSTON 

More  than  250,000  Booklets 
Nos.  1-24   are   in   Circulation 

One  fourth  to  one  half  of  their  cost  is  given  for 
many  kinds  of  benevolent  work. 

Membership,:     Members  are  entitled  to  a  copy 
of  each  of  the  publications  of  the  League  free. 
The  annual  membership  fee  is  one  dollar. 

BOOKLETS 

No.  1.     Hints  for  Health  in  Hot  Weather 

Two  cents  each,  $1.50  per  hundred. 

No.  2.     Milk 

By  Charles  Harrington,  M.D. 
Three  cents  each,  $2.50  per  hundred. 

No.  3.     "Colds"  and  their  Prevention 

Two  cents  each,  $1.50  per  hundred. 

No.  4.     Meat  and  Drink 

By  Ellen  H.  Richards. 

Three  cents  each,  $2.50  per  hundred. 

No.  5.     Healthful  Homes 

Four  cents  each,  $3.00  per  hundred. 

No.  6.     The  Successful  Woman 

By  William  R.  Woodbury,  M.D. 
Four  cents  each,  $2.50  per  hundred . 

No.  7.     The  Boy  and  the  Cigarette 

By  H.  Sterling  Pomeroy,  A.M.,  M.D. 
Five  cents  each,  $3.00  per  hundred. 

No.  8.     The  Care  of  Little  Children 

By  R.  W.  Hastings,  M.D. 

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Flies 

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BOOKLETS  (Continued) 

No.  11.     Tonics  and  Stimulants 

By  Ellen  H.  Richards. 

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No.  12.     Emergencies 

By  Marshal]  H.  Bailey,  M.D. 

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No.  13.     Microbes  Good  and  Bad 

By  Anne  Rogers  Win  slow. 

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No.  15.     The  Efficient  Worker 

By  Ellen  H.  Richards. 

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No.  16.     Sexual  Hygiene 

By  An  Experienced  Physician. 
,  Four  cents  each,  $2.50  per  hundred. 

No.  17.     Health  in  Labor  Camps 

Three  cents  each,  $1.75  per  hundred. 

No.  18.     Tuberculosis   (Consumption) 

By  Edward  O.  Otis,  M.D. 

Five  cents  each,  $3.00  per  hundred. 

No.  19.     When  to  Call  the  Physician 

By  George  W.  Gay,  M.D. 

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No.  20.    Habits  of  Health 

By  Paul  W.  Goldsbury,  M.D. 

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No.  21.     Wastes  and  their  Disposal 

By  Heni'y  J.  Barnes,  M.D. 

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No.  22.     Typhoid  Fever,  Infection  and 
Prevention 

By  Mary  Hinman  Abel. 

Five  cents  each,  $3.00  per  hundred. 

No.  23.     The    Observance     of     Health 
Day  in  Schools 

By  Thomas  F.  Harrington,  M.D. 
Four  cents  each,  $2.50  per  hundred. 

No.   24.     Industrial   Hygiene 

l'.\    Prof.  C  K.  A.  \Yin>lnw. 

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